Aim. To conduct a comparative analysis of individual cardiovascular risk (CVR) assessment using three versions of the SCORE scale and to evaluate the associations of risk with regional living conditions.Material and methods. Individual data from the cross-sectional phase of the ESSE-RF study in 2012-2014, 2017-2018, and 2020-2022 were used for the analysis. The analytical sample included 15,298 women and 10,861 men aged 40-64 years without a history of stroke, coronary heart disease, myocardial infarction, or diabetes, and without missing data. Individual CVR was assessed using the SCORE, SCORE2, and SCORE2-RF scales. The annual Economic, Demographic, Industrial, and Social Indexes of the National Medical Research Center for Therapy and Preventive Medicine were used as regional characteristics. Linear regression was used for quantitative outcomes, and logistic regression for binary outcomes. Logistic regression associations are expressed as odds ratios (ORs) and 95% confidence intervals.Results. According to the SCORE scale, the proportion of individuals with high/very high cardiovascular risk (CVR) is 2.2% among women and 28.8% among men; according to SCORE2, the proportions are 25.7% and 54.7%; and according to SCORE2-RF, the proportions are 6.8% and 12.9%, respectively. Improvements in demographics (only for women) and social conditions in a region are associated with a reduced likelihood of high/very high CVR. Thus, an increase in the quintile of the Demographic Index is associated in women with a decrease in the likelihood of high/very high CVR: according to SCORE OR=0.81 (0.73-0.90), according to SCORE2 OR=0.94 (0.90-0.97), according to SCORE2-RF OR=0.88 (0.83-0.94). An increase in the quintile of the Social Index in women is associated with a decrease in the likelihood of high / very high CVR: according to SCORE OR=0.85 (0.77-0.94), according to SCORE2 OR=0.95 (0.92-0.99), according to SCORE2-RF OR=0.93 (0.88-0.98). In men, an increasing Social Index quintile is associated with a decreased likelihood of high/very high cardiovascular risk: according to SCORE, OR =0.91 (0.87-0.96), according to SCORE2-RF, OR=0.92 (0.87-0.96).Conclusion. The study results suggest that the calibrated version of the SCORE2-RF scale is the most acceptable for practical use in preventive cardiology. Regional demographic and social conditions are associated with the profile of cardiovascular risk factors and can potentially be considered as population health factors. For Russia, a geographically diverse country, taking into account regional characteristics of the population allows for differentiation of prevention, as well as its focus and assessment of effectiveness.

Introduction — Both Russian and international studies demonstrate that living environment and neighborhood characteristics have influence on health status, including mental well-being. The aim of the study was to examine the associations between neighborhood environment and individual likelihood of stress among the Russian population. Material and Methods — The multicentre study “Epidemiology of Cardiovascular Diseases and Their Risk Factors in the Regions of the Russian Federation. Third Survey” was conducted in 2020-2022 across 15 regions of Russia. The analysis included 28,731 men and women aged 35-74 years. Neighborhood infrastructure was assessed using the Russian version of the NEWS questionnaire, while stress was measured with the Perceived Stress Scale (PSS; Cohen’s Scale). Associations between stress and neighborhood infrastructure characteristics were evaluated using logistic regression adjusted for covariates. Results were presented as odds ratios (OR) with 95% confidence intervals (CI). Results — A lower likelihood of stress was associated with shorter distances from the place of residence to facilities (OR=0.91; 95% CI 0.87-0.94), greater accessibility of key facilities (OR=0.51; 95% CI 0.48-0.55), and improved traffic-related safety (OR=0.60; 95% CI 0.56-0.66). In contrast, higher population density (OR=1.002; 95% CI 1.001-1.004), better pedestrian infrastructure quality (OR=1.16; 95% CI 1.10-1.22), and enhanced neighborhood aesthetics (OR=1.08; 95% CI 1.03-1.13) were associated with increased stress probability. Conclusion — The results of the study showed a substantial impact of certain neighborhood characteristics on stress, an indicator of mental health in the Russian population. The link between residential environment and mental health can be applicable in public health, policy-making, and urban planning.

Highlights Psycho-emotional stress is a significant risk factor for chronic non-communicable diseases, especially cardiovascular diseases, that simultaneously worsens the quality of life of patients with an existing pathology. Moreover, the issue of psycho-emotional stress at the population level in the Russian Federation remains understudied. To enhance prevention of chronic non-communicable diseases, especially cardiovascular pathology, the authors studied epidemiological features of psycho-emotional stress and formed a medical and social portrait of people suffering from high levels of psycho-emotional stress based on the representative samples of 27,950 participants aged 25-64 residing in 17 regions of the Russian Federation. Abstract Aim. To analyze socio-demographic, behavioral and biological determinants of the psychological stress (PS) at the population level of the Russian Federation (RF) to further advance the prevention of chronic non-communicable diseases. Methods. We studied representative samples of the population aged 25–64 years in 17 Russian regions (n = 27 950), examined as part of the Epidemiology of Cardiovascular Diseases in Regions of Russian Federation (ESSE-RF and ESSE-RF2, 2012–2014 and 2017) study. The subjects were interviewed using a questionnaire containing a section on the PS — Perceived Stress Scale-10. PS levels are ranked as follows: “Low” – 0–11, “Medium” – 12–19, “High” – 20–40. Results. Every fourth person in the Russian Federation (24,8%) experienced a high level of PS, moreover, higher age slightly affected the frequency of PS in both men and women. Determinants of high levels of PS include low level of education, low/moderate income, unemployment, low consumption of vegetables/fruits, short duration of sleep (5–6 hours), anxiety/depression, and a history of ischemic heart disease. Additionally, high levels of PS in women were associated with being single, smoking, having high salt intake, and stroke and cancer in medical history. High levels of PS in men were associated with ages 35–44 years, alcohol abuse, low physical activity, 9–10 hours of sleep, and low-density lipoproteins cholesterol level ≥ 3,0 mmol/L. Conclusion. We formed a medical and social portrait of people with high levels of PS which will help to develop targeted prevention programs to improve the quality of life for people with poor psycho-emotional health and to prevent chronic non-communicable diseases, including cardiovascular diseases.

Aim. To determine the level and prevalence of stress in individuals with noncommunicable diseases (NCDs).Material and methods. Representative samples of the population aged 25-64 years from 17 regions of the Russian Federation (n=27950) were included, examined within the ESSE-RF and ESSE-RF2 studies. To assess stress, the Perceived Stress Scale-10 was used. Stress levels were defined as follows: low — 0-11, moderate — 12-19, high — 20-40. The presence of diseases was recorded by a positive answer to the question: "Has a doctor ever told you that you have/had the following diseases?". Hypertension was defined as systolic blood pressure (BP) ≥140 mm Hg, and/or diastolic BP ≥90 mm Hg, and/or taking antihypertensive drugs. Obesity was defined as a body mass index ≥30,0 kg/m2, while abdominal obesity — as a waist circumference ≥102 cm in men and ≥88 cm in women. Blood biochemical tests included lipid profile assessment.Results. The stress level in the entire sample varied from 15,0 (myo­cardial infarction) to 16,6 (rheumatoid arthritis). When analyzing by sex, the highest stress score in women was observed in coronary artery disease — 17,6, while in men — in rheumatoid arthritis (15,1), cerebrovascular accident (15,1). More than a quarter of men with coronary artery disease (25,8%), prior cerebrovascular accidents (26,4%) had a high level of stress, while women with these diseases — 40,6%. Among the entire sample, the presence of each NCD, except for myocardial infarction, was characterized by a significantly higher stress level compared to participants without the corresponding disease.Conclusion. In the Russian population, individuals with NCDs are cha­racterized by higher stress rates compared to individuals without the corresponding disease. Among women, both the level and prevalence of stress are higher, and the list of diseases affecting the mental well-being is wider compared to men.

Aim. To evaluate the usage of antihypertensive drugs (AHDs) and their combinations in participants aged 35 to74 years with arterial hypertension (AH) in the population-based study ESSE-RF3.Material and methods. Representative samples of the population aged 35 to 74 years from 15 regions of Russia (n=28731) with a response rate over 70% were examined in the ESSE-RF3 study. Therapy received by 9944 participants with AH (with systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, or when the subject was taking AHDs) was analyzed. Information about AHDs intake (brand name of the drug) was recorded by questionnaire and coded according to International Nonproprietary Names by classes. Statistical analysis was performed using the open-source R 4.1 environment. Comparison of discrete indicators between groups was performed using Fisher’s exact test. The significance level for all tested hypotheses was taken as.05. The study was approved by the Ethics Committee of FGBI “NMRC TPM” of the Ministry of Health of the Russian Federation, each participant signed an informed consent.Results. Among the patients receiving therapy for AH, angiotensin-converting enzyme inhibitors (ACEIs) were used by 38.8% of participants, angiotensin receptor blockers (ARBs) — 31.6%, betablockers (BBs) — 29.0%, сalcium channel blockers (CCBs) — 21.5%, diuretics — 18.6%, 1.1% — outdated AHDs; 8.6% — other groups of drugs. Monotherapy was used by 53.1% of patients, 33.1% of participants received two, and 13.9% received three AHDs. Among participants taking two or more AHDs (including single-pill combinations (SPC)), males most often received the combination of BB+ ACEI and females — BB+ARBs. SPC AHDs were used by 10.3% of those receiving therapy (males: 9.8%, females: 10.6%). Among SPCs, the top three combinations were CCBs + ACEIs (28%), diuretics + ACEIs (27.5%), and diuretics + ARBs (24.4%).Conclusion. The population study ESSE-RF3, based on the survey of a representative sample of the Russian population aged 35-74 years, showed that more than a half of participants with AH receiving therapy were used the monotherapy, only every tenth of those treated received SPC. The problem of insufficient patients’ literacy was indicated — about 1% of patients received outdated AGPs. In addition, 8.6% of patients used non-AHDs for the treatment of AH. For improving the control of AH treatment, it is necessary to increase the adherence of patients to the prescribed therapy and more strict adherence of doctors to the published guidelines for AH treatment.

Экспертная оценка статьи "Ассоциация между смертностью от болезней системы кровообращения и депривацией у взрослого населения России" была выполнена на предмет её соответствия общим критериям качества научных исследований, таких как актуальность для здравоохранения, правильность выбора и использования статистических методов, достоверность и научно-практическая ценность результатов исследования, и отражает исключительно личную позицию рецензента.

Dietary habits affect the risk of all-cause mortality (ACM) in the adult population according to prospective studies.Aim. To assess the effect of dietary habits on the ACM risk in the Rus­sian population.Material and methods. The prospective cohort included represen­ta­tive samples of 10 Russian regions (n=17175, 6767 men and 10408 wo­men aged 25-64 years), examined in 2012-2014 as part of the ESSE-RF study. Dietary habits were studied based on the consumption rate of the main food groups. The vital status of the cohort was updated every 2 years. The follow-up period was 6 years. Kaplan-Meier curves were used to analyze overall survival (OS). Cox proportional hazards model was used to assess the ACM risk.Results. In the Russian population, an increase in OS is associated with daily consumption of vegetables/fruits, dairy products (milk, kefir, yogurt, cottage cheese, and cheese), and the presence of the Heal­thy Eating Model (HEM) in the diet. A decrease in OS is associated with excess salt intake (ESI) in the diet, the habit of adding salt to pre­pared foods, and daily consumption of pickles (p<0,05). Among men, an increase in OS is observed with daily consumption of fruits/ve­ge­tables, cheese, and HEM, while a decrease is observed with daily consumption of pickles, general ESI, and the habit of adding salt to foods (p<0,05). In women, daily consumption of red meat, liquid dairy products, cheese, and sweets is associated with an increase in OS (p<0,05). The risk of ACM in the general population and among men increases with ESI — relative risk (RR)=1,31 [1,06-1,61] (p=0,012) and 1,41 [1,06-1,87] (p=0,017), respectively, adding salt to food — RR=1,34 [1,09-1,65] (p=0,006) and 1,5 [1,13-1,98] (p=0,005) and daily consumption of pickles — RR=1,48 [1,02-2,14] (p=0,039) and 1,5 [1,01-2,54] (p=0,045). In women, regular consumption of red meat — RR=0,7 [0,49-0,99] (p=0,043), liquid dairy products — RR=0,68 [0,5-0,93] (p=0,015) and cheese — RR=0,64 [0,46-0,9] (p=0,011) were associated with an ACM decrease.Conclusion. An ACM risk increase in the general population and among men is associated with excess salt intake, and a decrease in ACM risk in women is associated with the regular inclusion of red meat and dairy products in the diet.

BackgroundThere are substantial regional differences in drinking alcohol in Russia, both at the population and individual levels. However, the causes of these differences have not been studied yet.AimThe goal of our study was to examine the effect of regional living conditions on individual alcohol consumption by the population of Russia.MethodsFor the analysis, we used data from a cross-sectional epidemiological study conducted in 2013‒2014. The final analytical sample included 18,130 people aged 25‒64 years. We conducted the interviews face to face, based on which any drinking in the last year, as well as alcohol abuse, were considered as a response. Alcohol abuse was recorded when the respondent consumed 5.75 or more grams of pure ethanol per day (75th percentile of average daily alcohol consumption among alcohol drinkers). The assessment of the regional living conditions was accomplished via integral indexing, which was previously performed based on publicly available data for 2010–2014. Associations were assessed using generalized scoring equations with unchanging standard errors. The associations were expressed by odds ratios (OR) and 95% confidence intervals (CI).ResultsDeterioration of social conditions and increase in demographic depression in the region of residence increased the odds of any drinking (OR 1.51, 95% CI: 1.33 to 1.72, P < 0.001 and OR 1.22, 95% CI: 1.05 to 1.41, P = 0.009, respectively). The odds of alcohol abuse increased with the deterioration of social living conditions and the growth of the industrial development in the region: OR 1.35, 95% CI: 1.14 to 1.59, P < 0.001 and OR 1.16, 95% CI: 1.05 to 1.28, P = 0.002, respectively.ConclusionOur analysis allowed assessing the impact of the regional living conditions on individual drinking alcohol in the population of Russia.

Aim . To assess the prevalence of type 2 diabetes (T2D) and prediabetes in the Russian population aged 25-64 years, as well as the association of prediabetes with risk factors (RFs) of noncommunicable disease. To study the contribution of carbohydrate metabolism disorders to mortality and the occurrence of cardiovascular events. Material and methods . We included data from cross-sectional studies ESSE-RF and ESSE-RF2. The final sample included 26418 people (10268 men and 16150 women) who signed informed consent. A modular questionnaire was used. Biochemical parameters were determined in the National Medical Research Center for Therapy and Preventive Medicine with an Abbott Architect c8000 autoanalyzer using diagnostic kits from Abbott Diagnostics (USA). Impaired fasting glycemia (IFG) was defined as a fasting plasma glucose concentration of 6,1-6,99 mmol/L. The presence of T2D was determined by interview and/or fasting plasma glucose ≥7,0 mmol/L. Obesity was defined as a body mass index of ≥30,0 kg/m 2 . Abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women. A prospective observation cohort was formed from 14 regions of ESSE-RF and ESSE-RF2 (n=22812). The vital status of each examined person was clarified once every 2 years. Information on fatal and non-fatal events was collected. Statistical processing was performed using the open-source statistical programming language and R environment (version 4.1). Associations were assessed using logistic regression. Kaplan-Meier curves were used to estimate survival. Associations with endpoints were assessed using Cox proportional hazards models. Results . In the Russian population aged 25-64 years, the prevalence of T2D and prediabetes, assessed by IFG, was 6,9% (men — 7,1%, women — 6,7%) and 6,2% (men — 7,7, women — 5,0% (p<0,001)), respectively. Age, low level of education, obesity, including abdominal obesity, hypertension, tachycardia, hyperuricemia and lipid metabolism disorders were significantly associated with prediabetes, and for men, additionally, stress. Prediabetes and T2D demonstrated a significant decrease of survival, including cardiovascular survival, and the occurrence of a composite endpoint. However, multivariate analysis adjusted for sex, age, and region of residence indicates a significant contribution of T2D, but not IFG. Conclusion . To reduce the T2D burden in the Russian Federation, patients with T2D should be identified early and RFs should be controled. Early detection of prediabetes plays a significant role in the prevention of T2D. In addition, T2D and prediabetes have common risk factors, and therefore common ways of prevention.

Research data indicate an increase in the risk of cardiovascular events (CVEs) with unhealthy diet.Aim. To assess the impact of diet on the development of cardiovascular events in the Russian population.Material and methods. The prospective cohort included representative samples of 10 Russian regions (n=17175, 6767 men and 10408 women aged 25-64 years), examined in 2012-2014 as part of the ESSE-RF study. The diet was studied by the frequency of consumption of the main food groups. The vital status of the cohort was clarified every 2 years. The follow-up period was 6 years. Kaplan-Meier survival curves were used to analyze survival, and the Cox proportional hazards model was used to assess the risk of CVEs.Results. Analysis of Kaplan-Meier curves showed better survival before the CVEs in the general population with daily consumption of cottage cheese (p=0,0029), cheese (p=0,00017), red meat (p=0,036) and the presence of the healthy eating model in the diet (p=0,013). A decrease in survival before the CVE onset was noted with excess salt intake (ESI) in the diet (p=0,0038) and the habit of adding salt to food (p=0,0032).Among men, a decrease in survival before the CVE onset was noted with ESI (p=0,018) and the habit of adding salt to food (p=0,047), and an increase — with regular consumption of red meat (p=0,00027). Among women, daily consumption of red meat (p=0,038), cheese (p=0,026), cottage cheese (p=0,019), as well as rare consumption of fatty dairy products (sour cream/cream) (p=0,04) delay the CVE onset. In the general population, in a univariate Cox proportional hazards analysis, daily cheese consumption and healthy eating model significantly reduce the risk of CVEs — 0,74 (0,61-0,89) and 0,78 (0,65-0,94), respectively, and excess salt and adding salt to food increase the CVE risk — 1,33 (1,12-1,59) and 1,33 (1,111,58), respectively. However, after introducing correction for socio-demographic indicators and risk factors, the significance is lost. In men, adding salt to food significantly increases the risk of cardiovascular events as follows: odds ratio 1,34 (1,04-1,73). Other eating habits are significant only in univariate analysis and lose their significance after introducing corrections.Conclusion. Adding salt to food significantly increases the risk of cardiovascular events among men of active working age.

Aim. To study the risk of type 2 diabetes (T2D) using the Finnish Diabetes Risk Score (FINDRISC) and its contribution to all-cause mortality and cardiovascular events in the Russian population aged ­25-64 years.Material and methods. Data from cross-sectional studies ESSE-RF and ESSE-RF2 are included. The random sample was formed using the Kish method. Response was ~80%. The modular questionnaire in­cluded socio-demographic variables, medical history, and main risk factors for noncommunicable diseases. Blood was collected from the antecubital vein on an empty stomach. Biochemical parameters were determined in the clinical diagnostic laboratory of the National Medical Research Center for Therapy and Preventive Medicine. The presence of T2D was determined by questionnaire and/or fasting plasma glucose level ≥7,0 mmol/L. Obesity was defined as a body mass index of ≥30,0 kg/m2; abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women. FINDRISC risk was graduated as follow: low (<7), slight (7-11), moderate (12-14), high (15-20), very high (>20). Persons with diabetes and pregnant women were excluded. The final sample included 26418 people (10268 men and 16150 women). From 14 regions, ESSE-RF and ESSE-RF2 formed a prospective follow-up cohort (n=22812), median follow-up — 7,5 years). Statistical processing was performed using the open-source statistical programming language and environ­ment R (version 4.1).Results. A fifth of people aged 25-64 years are at ≥ moderate risk of T2D. The rate of FINDRISC ≥15 was 10,1% (women 12,4% vs men 6,4%, p<0,001); ≥12 points — 23,7%. A close relationship was found between impaired fasting glucose and the risk of T2D with FINDRISC ≥15 and ≥12 (p<0,001). Survival worsens for FINDRISC ≥12 and ≥15, with the worst survival rates in individuals with T2D (p<0,001). The likelihood of cardiovascular events consistently increases with FINDRISC ≥12, ≥15, and T2D. In the Cox model, only T2D is significant for all-cause mortality; FINDRISC ≥15 and T2D are significant for the cardiovascular and combined endpoints.Conclusion. An important task of the medical community is to identify individuals at risk of T2D at the population level. Early prevention of T2D risk factors can delay or prevent both T2D and cardiovascular events.

Aim. To evaluate the contribution of arterial hypertension (AH), high lowdensity lipoprotein cholesterol (LDL-C) level and their combination to the development of (myocardial infarction) MI and stroke.Material and methods. The analysis is based on data from 1 and 2 observations of ESSE-RF study (Epidemiology of cardiovascular diseases in various regions of the Russian Federation)". A multi-s tage cluster random sample was used, formed according to the territorial principle on the basis of medical and preventive institutions (health facilities). Socio-demographic data (gender, age, education, wealth), smoking status and medical history were determined. Blood pressure (BP) was measured twice, on the right arm, in a sitting position with an automatic blood pressure monitor. Blood samples and its derivatives (serum and plasma) were stored at a temperature of -70ºC. LDL-C value was also included into analysis (LDl- C ≥3 mmol/l). Prospective monitoring of new cases was carried out in the initial sample without patients with coronary artery disease, MI, and stroke. The median follow-up time is 7.5 years. The sample size was 19 794. 356 non-fatal cases were identified, including 222 cases of MI and 174 cases of stroke.Results. The average age was 44.7 years, in men — 43.2, and in women — 45.3. The prevalence of isolated forms of hypertension, high LDL-C level and its combination were 12.7%, 30.3% and 32%, respectively. It was revealed that the age was the lowest in healthy and those with an increased LDL-C, whereas those with hypertension and combined conditions were older. The risk of nonfatal cases of MI and stroke in the Cox models, was adjusted for gender, age and region. There was a significantly higher risk of new cases of nonfatal CVD in individuals with isolated hypertension compared with those with isolated LDL-C.Conclusion. The frequency of isolated AH and isolated LDL-C were 13% and 30%, respectively. The combined condition was detected in 30%. The presence of AH, isolated LDL-C and their combinations in the sample doubled the risk of new CVD events.

High salt intake is a risk factor for the development of hypertension, most cardiovascular diseases and their complications.Aim. To study the characteristics of high salt intake in Russian and Moscow populations according to epidemiological studies.Material and methods. Data from representative samples of adult population aged 25-64 years (n=21922, 8372 men and 13550 women) from Russian 13 regions and persons aged >18 years (n=4063, 1662 men and 2401 women) from Moscow were used. A combination of 2 out of 3 items was taken as excess salt intake: daily consumption of meat and sausage products and pickles and/or adding salt to the finished dish. The results are presented as frequencies and odds ratios (OR).Results. The prevalence of high salt intake in the Russian population was 49,3% (53% among men and 47% among women); in the Moscow sample — 49,6% (60,3% for men and 41,9% for women). The habit of adding salt to a finished dish is widespread in the Russian Federation — 40,5% (47% among men and 34,7% among women); among Muscovites it is less pronounced — 25,8% (31,6% among men and 21,7% among women). Positive associations of high salt intake were noted with male sex (OR=1,1), education level (OR=1,5 and OR=1,3 for primary and secondary education, respectively), smoking (OR=1,74), alcohol consumption (OR=1,3, OR=1,4 and OR=1,5 — for moderate, high and very high alcohol consumption, respectively), rural place of residence (OR=1,34), anxiety (OR=1,27), depression (OR=1,36) and abdominal obesity (OR=1,1), and negative — with thyroid disease (OR=0,9), previous cerebral stroke (OR=0,8) and type 2 diabetes (OR=0,87). The prevalence of high salt intake in the all-Russian sample is not associated with income level and age, but was noted among Muscovites.Conclusion. In the Russian population, a high prevalence of high salt intake was revealed, which is more pronounced among smokers, alcohol drinkers, those with primary and secondary education levels, rural residents, as well as those with anxiety and depression.

Aim. To study the problem of obesity at the national level.Material and methods. The ESSE-RF3 study examined a representative sample of the population of 15 Russian regions aged 35-74 years with a response >70% (n=28731). Modular design questionnaire was used. The study received approval from the Independent Ethics Committee of the National Medical Research Center for Therapy and Preventive Medicine. Signed informed consent was obtained from each participant. Body mass (BM) was measured once with an accuracy of 100 g. The height was measured with an accuracy of 0,5 cm once in a standing position without shoes. Waist circumference was measured with a standard measuring tape with an accuracy of 0,5 cm. There were following BM categories: insufficient (BM index (BMI) <18,5), normal (18,5≲ BMI ≲24,9), overweight (25,0≲ BMI ≲29,9), class I obesity (30,0≲ BMI ≲34,9), class II obesity (35,0≲ BMI ≲39,9) and class III obesity (BMI >40). Abdominal obesity (AO) was assessed using the following criteria: waist circumference ≥102 cm and ≥88 cm for men and women, respectively. The changes of obesity were studied with the inclusion of materials from the ESSE-RF (2012-14) and ESSE-RF2 (2017) studies, carried out using the same methodology with ESSE-RF3 in the same age range of 35-64 years. Statistical analysis was carried out using the open-source R 3.6.1 environment. Analysis of associations between factors and a binary variable was carried out using the logistic regression method. The significance level for all tested hypotheses was 0,05.Results. Mean BMI values is 28,2±4,6 kg/m2 among men and 28,9±5,9 kg/m2 among women. The prevalence of overweight is 44,0 and 33,7%, obesity — 30,0 and 39,5%, AO — 30,9 and 55,1% among men and women, respectively. In addition, 30,3% have a combination of obesity and AO; obesity and/or AO — 49,1%. Obesity statistics did not significantly change, but in each section the rates are higher among women. The closest associations were found between obesity and hypertension (men: odds ratio (OR) (95% confidence interval) 2,88 (2,66-3,12), women: OR 3,03 (2,81-3,27) (p<0,001) and hyperuricemia for women (OR 4,21 (3,74-4,75) (p<0,001).Conclusion. A third of the Russian population is obese, and half has obesity and/or AO. This severity of the problem requires the development and adoption of a strategy to monitor obesity at the national level.

Aim. To assess the prevalence of psychological stress (PS) using the Perceived Stress Scale-10 (PSS-10) in various Russian regions and to analyze PS associations with socio-demographic characteristics and behavioral risk factors and some non-communicable diseases (NCDs). Material and methods. We studied representative samples of the population aged 35-74 years in the Russian regions, examined as part of the Epidemiology of Cardiovascular Diseases in Regions of Russian Federation-3 (ESSE-RF3) study. The subjects were interviewed using a questionnaire containing a section on the psychological stress — PSS-10. For men, PS levels are ranked as follows: "Low" — 0-11, "Medium" — 12-17, "High" — 18-40. For women, PS levels are ranked as follows: "Low" — 0-13, "Medium" — 14-19, "High" — 20-40. Statistical analysis was carried out using the open-source R 3.6.1 environment. Results. The average PS level was 12,0±7,3 (men: 10,7±7,0; women: 13,1±7,4). Every fifth person (20,3%) in the Russian population has a high PS level, with higher PS rates among women compared to men (high PS level — 21,6 vs 18,9%, respectively). A high PS level was associated with the income level (average or low), no marriage, unemployment, low level of physical activity, depression, anxiety, NCDs (type 2 diabetes, myocardial infarction, stroke), additionally for women — hypertension. Conclusion. The Russian population is characterized by a high PS prevalence, while PS rates are higher among women, which must be taken into account when predicting the NCD risks.

Aim . To assess the significance of troponin I (hs-cTnI) for cardio­vascular risk stratification in a population of Russian working-age men and women of. Material and methods . The data of 13976 men and women aged 25-64 from the ESSE-RF1 and ESSE-RF2 multicenter studies were analyzed. The examination included following points: standard questionnaire, measurements of height, weight, waist circumference, body mass index, blood pressure, pulse rate, biochemical tests. The level of hs-cTnI in blood serum samples stored at -70 о C in the Biobank of the National Medical Research Center for Therapy and Preventive Medicine was determined by chemiluminescent immunoassay analysis. Individual cardiovascular risk was calculated using the SCORE scale: values <1% — low risk; 1-4% — moderate, 5-9% — high and ≥10% very high. Similar to the BiomarCaRE study, participants were divided into 3 sex-adjusted cTnI levels: men <6, 6 to 12, and >12 pg/ml; women <4, 4 to 10, and >10 pg/ml. We analyzed following hard endpoints: cardiovascular death or non-fatal myocardial infarction, and composite endpoint: the same and stroke. Results . The prospective analysis of the relationship between troponin levels and endpoints and composite endpoints showed that in participants without prior CVD, hs-cTnI levels >12 pg/ml in men and >10 pg/ml in women are associated with an increased risk of endpoints and composite endpoints by 3,39 (1,91-6,03) and 2,69 (1,6-4,52) times (p<0,001), respectively. Similarly to BiomarCaRE, the SCORE-calculated risk reclassification was validated by adding the hs-cTnI value. The net reclassification improvement index (NRI) for endpoints and composite endpoints was 13% and 11% (p<0,001), respectively. Among men, the reclassification for NRI composite endpoints was more accurate than among women: 19% and 11%, respectively. Conclusion . The hs-cTnI level is an independent predictor of myo­cardial infarction, stroke, and death from CVD in people aged 35-64 years without prior CVD. Adding the hs-cTnI level to the SCORE model makes the risk prediction more accurate.

Aim. To analyze the prevalence of smoking according to the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study, and compare these data with the previous two stages. Material and methods. Data from following three cross sections of the ESSE-RF study were used: 2013-2014, 2017, 2020-2022. At the first stage, the prevalence and probability of smoking was assessed according to ESSE-RF3 data in 2020-2022 (n=28628, 35-74 years). At the second stage, an analysis was carried out over time using data from all three ESSE-RF sections (n=43804, 35-64 years). Results. In the overall ESSE-RF3 sample, the prevalence of smoking was 17,0% (men — 27,7%, women — 7,6%). Smoking probability varies significantly by sex, age, education level and income. Over time, the standardized prevalence of smoking increases from 25,0% in 20132014 to 26,2% in 2017, and then decreases to 21,5% in 2020-2022. Women are characterized by the same direction of trends, while men had consistent decrease in prevalence from 41,3 to 37,0 and 34,3%, respectively. The probability of smoking in 2017, relative to 20132014, decreases only in some socio-demographic categories of the population. In 2020-2022, a decrease in the probability of smoking is typical for both the general sample and all subgroups of the population. Conclusion. The results obtained characterize the current situation and time trends of the last decade and contain important information on smoking epidemiology in Russia.